The Child and Adolescent Trial for Cardiovascular Health (CATCH) is a 7.5 year (1987-1995) multi-site, randomized intervention trial in 96 schools. CATCH was designed to evaluate the effectiveness of a multiple component school-based intervention for promoting healthful behaviors in elementary school children (grades 3 to 5) to reduce their subsequent risk for cardiovascular disease. CATCH is the largest, most comprehensive elementary school health education research project ever undertaken testing the efficacy of longitudinal interventions in schools. During the CATCH intervention phase (Phase II) significant positive effects on intermediate variables have been observed. The main trial outcomes are still under analysis. This competing continuation proposes a four-year extended follow-up period to allow continued measurements on the cohort through ages 13 to 14 years old. The main goals of CATCH Phase III are two-fold. First, we will examine the maintenance of intervention effects on physiologic, behavioral, and psychosocial risk factors through early adolescence (6th through 8th grade). Second, CATCH III will provide the opportunity to assess the onset, development, and intercorrelation of cardiovascular risk factors from early to middle adolescence on a large, ethnically diverse group of students. Continuing to follow this cohort will create the opportunity to assess whether a pre-adolescent intervention can sustain behavioral and risk factor-level changes during early adolescence, the well known critical period of decline of most positive health behaviors. The study will significantly broaden our understanding of the course and determinants of physiologic, behavioral, and psychosocial risk factors for cardiovascular disease. CATCH III will have adequate samples to examine separate findings among important demographic subgroups such as males versus females, and whites versus blacks versus Hispanics. As a result, for the first time with a nationally representative multi-ethnic sample, variations between the genders and ethnic subgroups will be better understood.